Left Ventricular Mass is Independently Related to Coronary Artery Atherosclerotic Burden Feasibility of Cardiac Computed Tomography to Detect Early Geometric Left Ventricular Changes

Background: Left ventricular mass (LVM) is a predictor for adverse cardiovascular outcomes. Coronary atherosclerosis (coronary artery disease [CAD]) and concentric left ventricular (LV) remodeling are linked pathophysiologically by endothelial dysfunction. Aim: This study sought to determine the potential association between coronary atherosclerosis and LVM. Methods: A total of 2384 consecutive patients, without structural heart disease or a medical history of CAD, undergoing prospective mid-diastolic electrocardiogram-gated computed tomography coronary angiography were enrolled in the study. LVM and LV mid-diastolic volume were measured using semiautomated software and indexed to body surface area. The average LV mid-diastolic wall thickness and concentricity index (LVM/LV mid-diastolic volume) were calculated. According to the Agatston Score, the patients were divided into 3 groups (Agatston=0, 0.1 to 399.9, >= 400). Similarly, patients were also divided into 4 groups on the basis of the Total Plaque Score (TPS) (0, 1 to 4, 5 to 8, and >= 9). In addition, patients were categorized according to CAD (normal coronaries, nonobstructive CAD, and obstructive stenosis [obstruction >50%]). The association between the different categories of CAD and LV measures was assessed. Results: Both left ventricular mass index (LVMi) and the LV concentricity index increased with TPS categories from 55.3 +/- 12.1, 57.4 +/- 11.7, 60.9 +/- 13.6, and 63.7 +/- 15.3 g/m(2) (P<0.05), and 0.935 +/- 0.424, 0.975 +/- 0.3273, 1.046 +/- 0.431, and 1.138 +/- 0.443 mL/g (P<0.01), respectively. A similar trend of increasing LVMi was observed with increasing Agatston Score (P<0.001) and CAD category (P<0.05). Conclusion: In patients without known structural heart disease, LVMi is independently associated with measures of CAD.